Public has preconceived ideas on psychiatric therapy

Most people believe depression and schizophrenia warrant treatment with drugs and other “biological” approaches, but such care is less widely accepted for people with substance abuse problems, a new study shows.

The more likely people were to think that a mental health or substance abuse problem had biological roots—for example, genetic susceptibility or chemical imbalance—the more likely they were to support biological treatment for it, the researchers found.

“Further research is needed regarding why the US public does not endorse, overall, more formal, biologically oriented treatment options, and, specifically, medication,” Drs. Sara Kuppin of Columbia University in New York and Richard M. Carpiano of the University of Wisconsin at Madison conclude.

Public perceptions about appropriate treatment may play a key role in whether or not people decide to seek care for mental health problems, Kuppin and Carpiano note in the American Journal of Public Health. To better understand these perceptions, the researchers analyzed the results of the 1996 General Social Survey.

In the survey, 1,010 people were given a vignette describing a depressed individual, a person with schizophrenia, an alcohol- or drug-dependent person, or a “troubled person,” and asked what type of treatment they considered to be appropriate.

Treatment was classified as biological, which included seeing a psychiatrist, taking prescription medication, checking into a mental hospital or consulting a general medical doctor; or nonbiological, such as seeing a therapist, joining a self-help group, talking to family or friends, or talking with a member of the clergy.

Overall, the researchers found that more survey participants believed nonbiological treatments were more often appropriate than the biological treatments. Nearly 96 percent supported talking to family and friends, while fewer than 60 percent advocated medication.

For alcohol dependence, about 72 percent considered psychiatric treatment appropriate, while about 44 percent advocated medication; the percentages of people who approved such treatments for drug dependence was roughly similar.

Nearly three quarters of those surveyed thought drug treatment would be appropriate for depression, while about 85 percent endorsed medication for schizophrenia. Ninety-two percent thought a person with schizophrenia should seek psychiatric care, which about 77 percent thought appropriate for a person with depression.

Medication is increasingly being used to treat people with substance abuse problems, the researchers note.

“The majority of the lay public does recognize the need to seek formal (particularly biologically focused) treatment for depression and schizophrenia,” the researchers write. “However, the public is far more reluctant to endorse biologically focused treatments for substance abuse.”

Informing people about the biological roots of such problems may help broaden acceptance for this type of treatment, they conclude.

SOURCE: American Journal of Public Health, October 2006.

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